日本禁煙学会雑誌

第 9 巻第 3 号《原2014 年（平成 26 年）9 月 24 日著》

A survey of attitude about smoking,associated with periodontal disease anddental implants intended for
new patients hoping dental implants
Ken Yukawa, Noriko Tachikawa, Motohiro Munakata, Shohei Kasugai
Oral Implantology and Regenerative Dental Medicine,
Department of Masticatory Function Rehabilitation, Tokyo Medical and Dental University

Abstract
Objectives

The purpose of the current survey was to investigate the attitude of patients towards smoking and theirknowledge of smoking as a risk factor for periodontal disease and dental implants.
Methods

The subjects were new 1,585 patients who visited the clinic of the Tokyo Medical and Dental University
Hospital from January to December 2012 for an oral implant. The methodology included a questionnairesurvey about smoking status for the recognition of smoking as a risk factor for periodontal disease anddental implants and the Kano Test for Social Nicotine Dependence（KTSND）.
Results

The response number was 1,159 respondents（response rate, 73%）. Smoking was recognized as a risk
factor for periodontal disease by 621 patients（59%）and as a risk factor for dental implants by 234 patients（23%）. The KTSND scores of the patients with knowledge of smoking as a risk factor for periodontal
disease（621 patients, 59%）and for dental implants（234 patients, 23%）were significantly lower thanthose of the patients without knowledge of smoking as a risk factor for periodontal disease and for dental
implants, respectively.
Discussion

The recognition of smoking as a risk factor for periodontal disease and dental implants had an inﬂuence on
the smoking status and attitude.
Conclusion

In order to increase the recognition of smoking as a risk factor for periodontal disease and dental implants,
the informed consent process and patient education must be improved.
Key words

Dental implant, periodontal disease, smoking, smoking cessation, Kano Test for Social Nicotine Dependence（KTSND）

Contact address

Ken Yukawa
Oral Implantology and Regenerative Dental Medicine,
Department of Masticatory Function Rehabilitation, Tokyo Medical and Dental University
1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, JAPANTEL: +81-3-5803-4664
e-mail:
受付日 2013 年 8 月 27 日 採用日 2014 年 6 月 5 日

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Introduction

2014 年（平成 26 年）9 月 24 日

smoking experience, knowledge of smoking as a risk
factor for periodontal disease and dental implants,
and the KTSND（Appendix）.
The KTSND（version 2.1）consists of 10 questions with a choice of 4 responses: “Definitely Yes,”“ Probably Yes, ” “ Probably No, ” and “ Definitely
No” , which are scored as 3, 2, 1, and 0, respectively,
except for Question 1, which is scored in reverse
order. The individual scores for each question areadded to give a total KTSND score that ranges from0 to 30, with higher scores indicating a greater social
dependence on nicotine. The desired KTSND scoreis ≤ 9 10, 11）.
The smoking rates between men and women
were compared by using the Mann-Whitney test.
The KTSND scores were compared between nonsmokers, ex-smokers, and current smokers by using
the Games-Howell test. The KTSND scores werecompared between the subjects who answered “Definitely Yes” , “Probably Yes” , “Probably No” , and“Definitely No” by using the Games-Howell test.
The statistical software package PASW Statistics
version 18.0.0（SPSS Inc. SPSS Japan）was used forall statistical analyses. The statistical level of significance was set at p ＜ 0.05.
The survey was conducted in accordance with theguidelines of the ethics committee at Tokyo Medical and Dental University（accepted December 05
2011; accepted No. 733）.

Smoking is a risk factor for various diseases,
including periodontal disease1, 2）. The oral tissue ismost directly affected by smoking; carbon monoxide, a component of smoke, initially impedes
blood flow and thereafter impedes immune function. Smoking affects dental implants as well as thenatural teeth. Strietzel et al.3）identified smoking as
a risk factor for the survival rate of dental implants.
However, no study has been conducted in which thepatientsʼ knowledge regarding smoking as a risk factor for periodontal disease and dental implants was
surveyed.
The Kano Test for Social Nicotine Dependence（KTSND）4）is composed of 10 questions that reflect
3 factors: the smokerʼ s attempt to undervalue theharm caused by smoking, to overvalue the favorable effects of smoking, and to justify smoking as
an acceptable cultural and social behavior. Higher
KTSND score reflect an increased perception thatthe act of smoking is acceptable and justifiable,
indicating a greater social dependence on nicotine.
Smokers as well as non-smokers can answer thequestions in the KTSND. It is in the order corresponding to current smokers, ex-smokers, and nonsmokers 4 〜 9）. The scores change according to various
factors, such as smoking experience, occupation,and circumstance. However, no study has reported
the use of this survey in patients confined to or visiting dental hospitals.
The purpose of the current survey is to investigate
the attitude of patients towards smoking and theirknowledge of smoking as a risk factor for periodontal disease and dental implants.

Results
1. Patient characteristics（Table 1）

The questionnaire was distributed to a total of
1,585 patients, and the collection number was 1,358
respondents（collection rate, 87%）and the response
number was 1,159 respondents（ response rate,73%）. The mean age was 54.1 years, and the men:
women ratio was approximately 1: 2. The highest
proportion of subjects was aged 60 〜 69（29％）, followed by those aged 50 〜 59（27％）, 40 〜 49（21％）,30 〜 39（10 ％）, 70 〜 79（7%）, 20 〜 29（4%）, 80 〜
89（1%）, and 10 〜 19（1％）.
Overall, 144 patients（12%）were current smokers and 216（19%）were ex-smokers. Among men,

Materials and Methods

The study subjects were patients who visited theTokyo Medical and Dental University Hospital for
dental implants from January 2012 to December
2012.
The survey methods included administering questionnaires to patients（without writing down theirnames）and collecting and analyzing the data. The
questionnaires included questions about sex, age,

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2014 年（平成 26 年）9 月 24 日

Appendix The questionnaire that was distributed to the study subjects

A survey of attitudes associated with smoking,periodontal disease, and dental implants
Please circle the reply that best reflects your opinion.
Sex : Male or FemaleAge:1) Are you a smoker?
Ａ.Current smoker

Ｂ.Ex-smoker

Ｃ.Non-smoker

2) Do you think smoking is a risk factor of periodontal disease?
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
3) Do you think smoking is a risk factor of dental implants?
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 1: Smoking itself is a disease
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 2: Smoking is a part of culture
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 3: Tobacco is one of life’s pleasures
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 4: Smokers’ lifestyles may be respected
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 5: Smoking sometimes enriches people’s lives
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 6: Tobacco has positive physical or mental effects
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 7: Tobacco has effects to relieve stress1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 8: Tobacco enhances the function of smokers’ brains
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 9: Doctors exaggerate the ill effects of smoking
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
Q 10: People can smoke at places where ashtrays are available
1.Definitely Yes      2.Probably Yes      3.Probably No      4.Definitely No
End of all questions. Thank you for your cooperation.
Please submit it to the collection box.

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Appendix	
  1	

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2014 年（平成 26 年）9 月 24 日

Table 1 Patient characteristics
Total

Men

Women

1,585

636

949

Collection number (%)

1,358 (87)532 (84)826 (87)

Response number (%)

1,159 (73)414 (65)745 (79)

Mean age ±54.1 ± 15.6

53.4 ± 15.7

54.4 ± 15.6

7 (1)

2 (1)

5 (1)
25 (3)All subjects

SD

Age group (year, %)
10-19
20-29

48 (4)

23 (6)

30-39

119 (10)55 (13)64 (9)

40-49

239 (21)84 (20)155 (20)50-59

326 (27)112 (27)214 (29)60-69

334 (29)110 (26)224 (30)

70-79

76 (7)

21 (5)

55 (7)

80-89

10 (1)

7 (2)

3 (1)

Current smoker (%)

144 (12)85 (21)*59 (8)*

Ex-smoker (%)

216 (19)138 (33)

78 (10)Non-smoker (%)

799 (69)

191 (46)608 (82)

Smoking status

Age groups of current smokers (%)
10-19

1 (14)0 (0)1 (20)

20-29

9 (19)

6 (26)

3 (12)

30-39

26 (22)16 (29)10 (16)40-49

40 (17)19 (23)21 (14)50-59

44 (13)30 (27)14 (7)

60-69

23 (7)

16 (14)

7 (3)

70-79

2 (3)

0 (0)

2 (4)

80-89

1 (10)

1 (14)0 (0)* : The current smoking rate of males was significantly higher than was that of females (P < 0.05).

85 patients（21%）were current smokers and 138（33%）were ex-smokers. Among women, 59 patients（8%）were current smokers and 78（10%）
were ex-smokers. The current smoking rate among
men was significantly higher than that among women. The highest proportion of current smokers wasaged 30 〜 39（22%）, followed by those aged 20 〜
29（19%）, 40 〜 49（17%）, 10 〜 19（14%）, 50 〜
59（13%）, 80 〜 89（10%）, 60 〜 69（7%）, and 70〜 79（3%）.
2. KTSND scores（Table 2）

The mean KTSND scores of the current smokers, ex-smokers, and non-smokers were 17.7 ± 5.2，
15.6 ± 6.5, and 14.3 ± 7.0, respectively. The KTSND
score of the current smokers was significantly higher
than those of the ex-smokers and non-smokers. The
KTSND score of the ex-smokers was significantly-smokers.
For questions 1,
higher than that of the nonTable
14, 9, and 10, the KTSND scores of the current smokers were significantly higher than those of the nonsmokers; further, for questions 4 and 9, the KTSND
scores of the current smokers were significantly
higher than those of the ex-smokers.

3. Knowledge of smoking as a risk factor forperiodontal disease and dental implants（Table 3）

Regarding periodontal disease, 621 patients（59%）replied “Definitely Yes” , who had the knowledge of smoking as a risk factor for periodontal disease. Out of these, 65 were current smokers（23%）,
146 were ex-smokers（68%）, and 410 were nonsmokers（60%）. For dental implants, out of all of
the respondents, 234 patients（23%）replied “Definitely Yes.” Out of these, 34 patients were current

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2014 年（平成 26 年）9 月 24 日

Table 2 The Kano Test for Social Nicotine Dependence (KTSND) scores according to smoking

statusQ 1: Smoking itself is a disease

Current smokers

Ex-smokers

Non-smokers

Mean ± SD

Mean ± SD

Mean ± SD

1.05 ± 0.96

1

1

Q 2: Smoking is a part of culture

1.19 ± 0.09*
1.23 ± 0.98

1.42 ± 1.11

0.93 ± 0.95*
1.11 ± 0.99

Q 3: Tobacco is one of life’s pleasures

2.02 ± 0.94

2.06 ± 1.07

1.81 ± 1.11

1.60 ± 0.89*
1.34 ± 0.81

2

1.20 ± 0.97*
1.30 ± 0.99

1.02 ± 0.93*
1.14 ± 0.96

1.24 ± 0.84

1.05 ± 0.91

1.00 ± 0.95

1, 2

Q 4: Smokers’ lifestyles may be respected
Q 5: Smoking sometimes enriches people’s lives
Q 6: Tobacco has positive physical or mental effects

1

Q 7: Tobacco has effects to relieve stress1.83 ± 0.73

1.67 ± 0.93

1.43 ± 0.97

Q 8: Tobacco enhances the function of smokers’ brains

1.01 ± 0.84

0.76 ± 0.79

0.81 ± 0.84

20.63 ± 0.84*

Q 9: Doctors exaggerate the ill effects of smoking

1.13 ± 0.90*

Q 10: People can smoke at places where ashtrays are available

1, 2
10.62 ± 0.81*
2.03 ± 1.08

3, 4

4, 5

2.29 ± 0.88*

Total KTSND score17.7 ± 5.2*

15.6 ± 6.5*

1, 2

1.93 ± 1.06*
14.3 ± 7.0*

1

3, 5

1

* : The KTSND score of current smokers was significantly higher than was that of non-smokers (P < 0.05).
2* : The KTSND score of current smokers was significantly higher than was that of ex-smokers (P < 0.05).
3* : The total KTSND score of current smokers was significantly higher than was that of non-smokers (P < 0.05).
4* : The total KTSND score of current smokers was significantly higher than was that of ex-smokers (P < 0.05).
5* : The total KTSND score of ex-smokers was significantly higher than was that of non-smokers (P < 0.05).

Table 3 The KTSND scores according to knowledge of smoking as a risk factor for periodontal
Table 2disease and dental implants
Knowledge of smoking related to periodontal disease
AnswerCurrent smokers(%)
Ex-smokers(%)
Non-smokers(%)
Total (%)
KTSND

Definitely Yes

Probably Yes

Probably No

Definitely No

65 (45)57 (39)16 (11)6 (5)146 (68)45 (20)20 (9)3 (2)410 (60)

178 (26)75 (11)21 (3)

621 (59)282 (27)

13.3 ± 7.0*

1, 2, 317.5 ± 5.6*

113 (11)1

16.7 ± 5.6*

31 (3)
2

16.6 ± 7.2*

3

Knowledge of smoking related to dental implants
AnswerCurrent smokers(%)
Ex-smokers(%)
Non-smokers(%)
Total (%)
KTSND

Definitely Yes

Probably Yes

Probably No

Definitely No

34 (23)55 (28)46 (32)9 (6)83 (39)61 (28)68 (32)2 (1)118 (17)202 (30)342 (50)

23 (5)

234 (23)318 (31)13.6 ± 7.3*

4, 5, 616.5 ± 6.2*

456 (44)4

17.7 ± 6.7*

34 (3)
5

17.4 ± 6.4*

61

* : The KTSND score of “Definitely Yes” was significantly lower than was that of “Probably Yes” (P < 0.05).
2* : The KTSND score of “Definitely Yes” was significantly lower than was that of “Probably No” (P < 0.05).
3* : The KTSND score of “Definitely Yes” was significantly lower than was that of “Definitely No” (P < 0.05).
4* : The KTSND score of “Definitely Yes” was significantly lower than was that of “Probably Yes” (P < 0.05).
5* : The KTSND score of “Definitely Yes” was significantly lower than was that of “Probably No” (P < 0.05).
6* : The KTSND score of “Definitely Yes” was significantly lower than was that of “Definitely No” (P < 0.05).
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Table 3

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smokers（23%）, 83 were ex-smokers（39%）, and118 were non-smokers（17%）.
The mean KTSND score of the subjects answering “Definitely Yes” regarding knowledge of smoking as a risk factor for periodontal disease was 13.3
± 7.0, that of “ Probably Yes” was 17.5 ± 5.6, that of “Probably No” was 16.7 ± 5.6, and that of “ Definitely
No” was 16.6 ± 7.2. The KTSND score of the group
who answered “Definitely Yes” was significantly
lower than those of the other groups. Moreover, themean KTSND score of subjects answering “ Definitely Yes” regarding knowledge of smoking as arisk factor for dental implants was 13.6 ± 7.3, thatof “ Probably Yes” was 16.5 ± 6.2, that of “ Probably
No” was 17.7 ± 6.7, and that of “ Definitely No” was17.4 ± 6.4. The KTSND score of the group who answered “Definitely Yes” was significantly lower thanthose of the other groups.

2014 年（平成 26 年）9 月 24 日

score of these subjects was 17.3 ± 5.6. Smoking was
regarded as a risk factor for both periodontal disease
and dental implants by 226 patients（19%）because
they answered “Definitely Yes” for both questions;these subjects are hereinafter referred to as the YY
group. The KTSND score of these subjects was
13.6 ± 7.3. Further, 385 patients（33%）thought thatsmoking is a risk factor for periodontal disease because they answered “Definitely Yes” for questions
regarding periodontal disease; these subjects are
hereinafter referred to as the YN group. The KTSND
score for these subjects was 13.2 ± 6.8. Finally, 8 patients（1%）thought that smoking is a risk factor for
dental implants because they answered “Definitely
Yes” for questions regarding dental implants; thesesubjects are hereinafter referred to as the NY group.
The KTSND score of these subjects was 13.4 ± 8.8.
The KTSND scores of the NN group were significantly higher than those of the YY and YN groups.

4. Relationship between the KTSND scoresand the knowledge of smoking as a risk fac-

Discussion

tor for periodontal disease and dental im-

The Health, Labor, and Welfare Ministry12）reported that the percentage of current smokers was
20.1% in 2011, while the percentage in this study
was 12%. Further, they reported that 37.3% of themen and 10.2% of the women in their 50s were current smokers, and 29.3% of the men and 6.4% of thewomen in their 60s were current smokers. In thisplants（Table 4）

Smoking was not regarded as a risk factor for
either periodontal disease or dental implants by 540
patients（47%）because they did not answer “Definitely Yes” to either question; these subjects are
hereinafter referred to as the NN group. The KTSND

Table 4 Relationship between the KTSND scores and knowledge of smoking as arisk factor for periodontal disease and dental implants
StatusSubjects (%)

KTSND score

Patients who think smoking is not a risk factor for either
periodontal disease or dental implants (NN)540 (47)

17.3 ± 5.6*

Patients who think smoking is a risk factor for both
periodontal disease and dental implants (YY)

226 (19)

13.6 ± 7.3*

1

Patients who think smoking is a risk factor forperiodontal disease (YN)

385 (33)

13.2 ± 6.8*

2

8 (1)

13.4 ± 8.8

Patients who think smoking is a risk factor for dental
implants (NY)1,2

1

* : The KTSND score of NN was significantly higher than was that of YY (P < 0.05).
2* : The KTSND score of NN was significantly higher than was that of YN (P < 0.05).

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Table 4

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study, the rate of current smokers was 27% for men
and 7% for women in their 50s, and 14% and 3%,
respectively, for those in their 60s. Therefore, theseresults showed a trend similar to that of the Health,
Labor, and Welfare Ministry. The reason for the low
percentage of total current smokers in this study
was presumably due to the men: women ratio of 1:
2. It was easier for women to visit our clinic thanmen, because our consultation time was from 0900
to 1600, and the smoking rate among women was
lower than that among men. As a result, the smoking
rate was low in this study.
Smoking is a risk factor for various diseases.
Smoking was reported as a risk factor for periodontal disease by Heber et al.1）and Genco et al.2）,
for the loss of periodontal tissue by Haffajee al.13）,
and for dental implants by Strietzel et al.3）and Liddelow et al.14） In order to maintain oral health, allpatients must have proper information and the rateof smoking should be 0%. In this study, 59% of patients had knowledge of smoking as a risk factor forperiodontal disease, whereas 23% of patients had
knowledge of smoking as a risk factor for dental
implants（Table 3）. Awareness of an increased riskfor dental implants was very low compared to thatof regarding periodontal disease. However, Lunget al.15）reported that only 6% of their respondents
were specifically aware of the link between smoking
and periodontal disease. The patients who visitedthe university hospital were often referred by othergeneral practices; thus, they had already received
instructions regarding dental treatments, including
smoking cessation. In recent years, dental implants
have rapidly become popular Japan. Imakita et al.16）
reported that the number of new patients who visited our clinic in 2012 was decupled the number ofpatients in 1996. Therefore, the difference in knowledge regarding dental implants between doctors andpatients was very large, and almost all patients were
unaware of the risk factor for dental implants. Doctors should provide information regarding dental
implants, including the risk factor, before obtaining
informed consent, and they must educate patients
about the benefits of smoking cessation.

2014 年（平成 26 年）9 月 24 日

Yoshii et al.8）reported that KTSND scores of 18.0
± 5.0, 12.2 ± 4.9, and 12.2 ± 5.3 were obtained incurrent smokers, ex-smokers, and non-smokers,
respectively. In this study, scores of 17.7 ± 5.2, 15.6
± 6.5, and 14.3 ± 7.0 were obtained in current smokers, ex-smokers, and non-smokers, respectively（Table 2）. The patientsʼ mean age in this study was
54.1 ± 15.6, and the patients in this age group would
not have received sufficient education regarding
smoking cessation as youths. Therefore, the KTSND
scores in this study were relatively high. Recently,
the Health, Labor, and Welfare Ministry 12）reported
that 74% of the patients with periodontal disease
were in their early 20s and 85% were in their early
60s. On the basis of these results, in 2004, the Japanese Society of Periodontology17）named smoking
cessation, which was positively related decrease
periodontal diseases; therefore, the patients who
visited the clinic should be recognized smoking
as a risk factor for periodontal disease. Similarly,
the Japanese Society of Oral Implantology18）madea non-smoking declaration in 2010. Although differences exist in the awareness of smoking as arisk factor between periodontal disease and dental
implants, almost all societies recommend smoking
cessation. In this study, the KTSND scores of thesubjects who answered “Definitely Yes” regardingknowledge of the association between smoking
and periodontal disease（13.3 ± 7.0）and dental implants（13.6 ± 7.3）were lower compared to those of
the other subjects（Table 3）. Further, when viewed
individually, the KTSND score of the NN group
was higher than those of the other subjects（Table4）. Therefore, patient education regarding dental
therapy potentially decreased the KTSND scoresof these subjects. However, Yoshii et al.9）reported
that the desired KTSND score is ≤ 9. In addition, theboundary value between normal and high KTSND
scores was set as 10, based on the results of a survey
administered to the attendees of a tobacco control
meeting who were not socially dependent on nicotine10）. In this study, no group obtained a score ≤ 9.
The KTSND questionnaire is comprised of 10questions related to 3 factors: justifying smoking as

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2014 年（平成 26 年）9 月 24 日

A part of this study was presented at the 10 th Asia
Pacific Conference on Tobacco or Health（August
2013, Tokyo）.

an acceptable cultural and social behavior, overvaluing the favorable effects of smoking, and undervaluing the harm caused by smoking4）. Questions 2, 3,
4, and 5 are related to the justification of smoking
as an acceptable cultural and social behavior, whilequestions 6, 7, and 8 are related to overvaluing thefavorable effects of smoking. Questions 1, 9, and 10
are related to undervaluing the harm of smoking. In
this study, the KTSND scores of current smokers for
Q1, 4, 9, and 10 were significantly higher than were
those of non-smokers. Moreover, the KTSND scoresof current smokers for Q4 and 9 were significantly
higher than those of ex-smokers（Table 2）. Therefore, this study suggests that current smokers tend toboth glamorize smoking and underestimate the harm
it causes.
The doctor and the patient must remind themselves of the fact that smoking is a risk factor forvarious diseases. Regarding periodontal disease,current smokers have dark gum color, less blood
flow, stained teeth, and bad breath. Although patients can directly evaluate their oral health themselves, they cannot evaluate their lungs. It is important for current smokers to realize the result ofsmoking cessation every day. However, this study
could not show the best instruction for dental patients. Further studies are necessary to investigate
the optimal patient education and informed consent
processes, including smoking cessation.

References
1） Haber J, Kent RL: Cigarette smoking in a periodontal practice. J Periodontol 1992; 63: 100-106.
2） Genco RJ, Borgnakke WS: Risk factors for periodontal disease. Periodontol 2000 2013; 62: 5994.
3） Strietzel FP, Reichart PA, Kale A, et al: Smoking
interferes with the prognosis of dental implant
treatment: a systematic review and meta-analysis.
J Clin Periodontol 2007; 34: 523-544.
4） Yoshii C, Kano M, Isomura T, et al: An innovative
questionnaire examining psychological nicotine
dependence, "The Kano Test for Social Nicotine
Dependence（KTSND）". J UOEH 2006; 28: 4555.
5） Kurioka N, Inagaki K, Yoshii C, et al: Investigation of the perception of female students towards
tobacco smoking with The Kano Test for Social
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9） Yoshii C, Inoue N, Yatera K, et al: An evaluationof social nicotine dependence of participants at theannual meeting of the Japan lung cancer society
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10）Yoshii C, Kurioka N, Kano M, et al: The Kano
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Conclusions

In this study, 59% of patients recognized smoking as a risk factor for periodontal disease, whereas
23% recognized smoking as a risk factor for dental
implants. The KTSND score of the patients who recognized smoking as a risk factor for both periodontal
disease and dental implants was significantly lower
compared to those of the other subjects. However,none of the KTSND scores in this study reached thedesired KTSND score. In order to increase the recognition of smoking as a risk factor for periodontal
disease and dental implants, the informed consent
process and patient education must be improved.

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12）Ministry of Health, Labour and Welfare: The
national health and nutrition examination survey in 2011 [in Japanese]. Retrieved Decem ber 6, 2011, from http://www.mhlw.go.jp/stf/
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about/kinen.html

歯科インプラント科初診患者を対象とした歯周病と歯科インプラントに関与する喫煙の意識調査
湯川健、立川敬子、宗像源博、春日井昇平

東京医科歯科大学医歯学総合研究科インプラント・口腔再生医学分野【目 的】 喫煙が歯周病と歯科インプラントの危険因子になることを認識しているかの患者意識調査である。
【方 法】 2012 年 1 月から 12 月に東京医科歯科大学歯学部附属病院インプラント科に来院した初診患者 1,585人を対象とし、質問紙票（喫煙状況、喫煙による歯周病と歯科インプラントへの影響の認識、社会的ニコチン依存度（Kano Test for Social Nicotine Dependence : KTSND））を用いて調査した。
【結 果】 有効回答数は 1,159 枚（73％）であった。KTSND において、喫煙が歯周病の危険因子になると認識していたもの（621 人、59％）と、歯科インプラントの危険因子になると認識していたもの（234 人、23％）の値が、認識していないものより有意に低かった。
【考 察】 歯周病と歯科インプラントの危険因子を認識することは、喫煙状況と意識に影響を与えることが示唆された。
【結 論】 喫煙が歯周病・歯科インプラントの危険因子になる認識をあげるためには、インフォームドコン
セントと患者教育を充実させる必要がある。
キーワード：歯科インプラント、歯周病、喫煙、禁煙、加濃式社会的ニコチン依存度質問票（KTSND）

A survey of attitude about smoking among dental implants

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